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Yaroustovsky et al. Vessel Plus 2019;3:9 I http://dx.doi.org/10.20517/2574-1209.2019.02 Page 7 of 11

Table 5. Changes of hematological and hemostatic parameters in the H.E.L.P.-apheresis group
Indices Before procedures After procedures P value
Hemoglobin, g/L 131 (128-137) 116 (112-127) 0.001
Hematocrit, % 39 (38-42) 35 (34-38) 0.001
9
Platelets, 10 /L 189 (172-218) 164 (149-178) 0.001
9
WBC, 10 /L 5.9 (4.8-8.4) 5.6 (4.3-7.1) 0.002
ESR, mm/h 15 (12-20) 3 (2-4) 0.001
Fibrinogen, g/L 4.5 (4.2-5.2) 1.92 (1.57- 2.31) 0.001
International Normalized Ratio INR 1.02 (0.97-1.12) 1.53 (1.33-1.76) 0.001
Antithrombin, % 114 (104-118) 78 (72-79) 0.001

WBC: white blood cells; ESR: erythrocyte sedimentation rate; INR: International Normalised Ratio

Table 6. Changes of hematological and hemostatic parameters in the lipid-filtration group
Indices Before procedures After procedures P value
Hemoglobin, g/L 148 (145-153) 138 (134-144) 0.001
Hematocrit, % 45 (43-46) 41 (39-43) 0.001
9
Platelets, 10 /L 209 (199-221) 184 (167-202) 0.001
9
WBC,10 /L 8.4 (7.4-9.3) 10.2 (9.7-10.3) 0.002
ESR, mm/h 5 (4-6) 2 (2-3) 0.012
Fibrinogen, g/L 3.9 (3.7-4.0) 2.0 (1.8- 2.2) 0.001
INR 1.00 (0.93-1.05) 1.26 (1.17-1.37) 0.001
Antithrombin, % 99 (95-109) 83 (73-94) 0.043
WBC: white blood cells; ESR: erythrocyte sedimentation rate; INR: International Normalised Ratio

observed decrease of LDL level, we pointed out positive correlation changings of atherogenic (LDL) and
antiatherogenic (HDL) lipid fractions. This was approved by the change of apoprotein index apo B100/apo
A-I and by the dynamics of atherogenic index [15,30] .

One explanation for the beneficial effect on vascular endothelium (and as a consequence, decrease of acute
[20]
cardiovascular events frequency) is shock pulse decrease of atherogenic lipoproteins after the treatment .
The solution of this problem is lipid apheresis [33-35] .

Some researchers observe that simultaneous decrease of prothrombotic factors and atherogenic lipoproteins
during lipid apheresis also can favour endothelium dysfunction improvement, inhibiting the progression of
atherosclerotic damage and stabilizing the existing plaque [21,37] .

It is known that the elimination of fibrinogen (more than 60%) and large-molecular substances according
to the lipid apheresis techniques affects the blood and plasma viscosity, rheological characteristics and
aggregation properties of cells (erythrocytes, platelets) [37,38] . Terai et al. (2010) noted that changes of retina
[39]
vessels’ diameter are connected with systemic effect of LDL-apheresis, making basis for ocular perfusion
improvement in the patients with hypercholesterolemia. In our study, positive feedback from the patients
about subjective state improvement, particularly, increase of tolerance to the exertion, no drowsiness,
productivity improvement, no dizziness, decrease of heart attacks was explained by objective findings,
concerning decrease of large lipid molecular and fibrinogen levels, and as a consequence rheological blood
characteristics improvement and microcirculation.

It should be noted a number of important pleiotropic and non-lipid, anti-inflammatory and rheological
[43]
effects during the selective lipid apheresis [37,40-42] . Hibino et al. (2009) demonstrated anti-inflammatory
[44]
and homeostasis-correcting effects of cascade rheofiltration. Hovland et al. (2010) studied the influence of
different lipid apheresis therapies (DALI-hemoperfusion, plasma sorption LA-15 and cascade rheofiltration